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UNITED STATES PUBLIC HEALTH SERVICE 



RURAL SCHOOLS 

SANITARY SURVEY OF SCHOOLS IN 
BARTHOLOMEW COUNTY, IND. 



BY 

J. A. NY-DEGGER 

Surgeon, United States Public Health Service 



REPRINT NO. 177 

FROM THE 

PUBLIC HEALTH REPORTS 

February 6, 1914 




"WASHINGTON 

GOVERNMENT PRINTING OFFICE 

1914 



I O 



Monograph 



til I 



n. OF D, 

MAY 23 S914 






RURAL SCHOOLS.^ 
SANITARY SURVEY OF SCHOOLS IN BARTHOLOMEW COUNTY, IND. 

By J. A. Nydegger, Surgeon, United States Public Health Service. 

The survey of the schools of Bartholomew County was made upon 
the request of the health commissioner of the county of Bartholomew 
and the secretary of the Indiana State Board of Health. Work was 
begun September 23, 1913. It was planned that the scope of the 
survey should include : (1) a medical inspection of the school children 
of the public and parochial schools, ^Yith especial reference to the 
occurrence of contagious and infectious diseases, particularly tra- 
choma, and the extent of existence of defective teeth, hypertrophied 
tonsils, and adenoids, and (2) a sanitary inspection of the school 
buildings, grounds, outhouses, etc. 

In order to have the inspection reports uniform, and also to expe- 
dite the work of the survey, a blank form for use in making the 
inspections was prepared. This form embraced some 36 items of 
medical and sanitary information relating to the pupils and schools, 
to be obtained at each school visited. 

Bartholomew County is one cf the large counties of Indiana. It 
lies in the southeastern part of the State and has an area of some 400 
square miles. The surface in the greater part is level or roUing, but 
in the western section of the county is broken up and quite hilly. The 
White River and its tributaries traverse the county in a general 
direction from north to south. The lowlands are very fertile. Here 
the suface is overlaid with, a deep humus, in part mixed with gravel 
from former river washings, with a gravelly substratum. The hilly 
section is mostly hard clay soil mixed with shale, with shaly sub- 
strata. This makes a permanent water supply a matter of some 
difhculty without going to a considerable depth. 

The estimated population of the county is 28,000. The taxable 
basis is $20,000,000. Columbus, the county seat, a modern, pros- 
perous city, of some 11,000 people, is centrally located in the county. 
There are a number of other to^vns. Of these, Hope is the largest 
after Columbus. Excellent roads form an extensive network over 
the county. 

Schools. 

The county is subdivided into 14 townships. The to^vnsliips con- 
tain from 4 to 10 schools each, according to size and population. 
Consolidated schools have recently been erected in a number of towTi- 

i Reprint from the Public Health Reports, vol. 29, No. 6, Feb. 6, 1914. 
38212°— 14 3 



4 SCHOOL SANITAKY SUEVEY, BARTHOLOMEW COUNTY, IND. 

ships, thereby greatly lessening the total number of schoolhouses in 
the county. 

A single school trustee is responsible for the schools in a township, 
except where there are municipal or ^dllage schools, and he provides 
for new school buildings, maintenance of buildings, employment of 
teachers, etc., ^nd has general supervision of the school property. 
It is a pleasure for me here to refer to the great interest and pride 
some of these trustees take in their duties. 

In all, I visited and investigated 83 schools. Fifty-seven, or 69 
per cent, were one-room rural district schools; seven, or 8 per cent, 
were two and three room rural schools; six, or 7 per cent, were con- 
soHdated schools with from three to nine rooms each; three, or 3.6 
per cent, were parochial schools; two, or 2.5 per cent, were village 
schools; and eight schools, or 9 per cent, were in the city of Columbus. 
These schools employ 173 teachers. In all 3,969 school children 
were inspected. 

Twenty-six frame schoolhouses were inspected. Twenty-three 
were one-room rural schools, one was a three-room town school, and 
two were in the city of Columbus. 

Area and Condition of School Yards. 

In the towns, as a rule, the school yards are of ample size and well 
kept, graded, and subdrained. The same may be said of the grounds 
belonging to the consolidated township schools. Here the yards are 
of ample size, and on the whole graded, clean, and well poHced. The 
yards of the rural schools average from an acre in dimension to a 
third of an acre. About 90 per cent of the rural-school yards are 
level, some are sloping, and stiU a few others are decidedly abrupt 
and badly adapted for such purposes. The large majority of these 
yards were found to be fairly well policed, while some appeared to 
be practically neglected, with litter and rubbish lying about. 

Drainage. 

The school yards in most instances are sufficiently well drained. 
Some are drained well by the nature of the soil and others by the 
contour of the surface. Many of the yards are partly gravel in com- 
position and porous, and drain quickly. At the large majority of 
schools the surface drainage from the outhouses is away from the 
buildings and weUs, while at a limited number it is directly toward 
the buildings and weUs. 

Outhouses and Excreta Disposal. 

In Columbus, where a water-carriage system exists, aU of the 
schools are supplied with flush-out closets and urinals, with the excep- 
tion of two, the kindergarten and the Booker T. Washington Colored 



SCHOOL SANITAKY SURVEY, BARTHOLOMEW COUNTY, IND. 5 

School. The former is furnished with a single outhouse in the school 
yard, provided with a brick vault. The outhouse is clean and well 
kept, but no screen is provided in front of entrance. The vault is in 
fair sanitary condition. Odors, however, were present. The Booker 
T. Washington School is provided with a double frame outhouse in 
the yard, supplied with screens in front of entrances for each sex. 
Brick vaults are furnished and have sewer connections. This out- 
house is in good sanitary condition. 

The Hartsville School is provided with new frame outhouses, prop- 
erly separated for the sexes, screened entrances, and concrete vaults, 
trapped at rear to permit of access for emptying. The outhouses are 
not provided with screened openings for ventilation. Otherwise the 
buildings are good and suitable. 

In the one and two room rural schools the sanitary condition of 
the outhouses was classified as follows: 



Name of township. 


Total 

number 

outhouses. 


Outhouses 
in good 
sanitary 

condition. 


Outhouses 

in fair 

sanitary 

condition. 


Outhouses 

in bad 

sanitary 

condition. 


Harrison . 


7 
5 
6 
10 

4 
6 
6 
5 
4 
2 

2 




1 
2 
2 
3 
3 
2 
2 


6 


Rockcreek 




3 


Nineveh ' 

Wayne 

Columbus 


i 

1 


3 


4 


Jackson . . . 




2 


Sandcreek 




4 


Union 


1 


5 


Clay 

Ohio 







5 




4 
1 
1 




Flatrock . . . 




1 


German 




1 


Clifty 




2 






Total 


6:3 


3 


21 


42 



The outhouses at about 2 per cent of the rural schools are provided 
with vaults. In the remainder the excreta is received upon the 
surface of the ground. In many the conditions were unspeakably 
dirty and insanitary, being filled with excreta almost to the seat. 
In a small percentage of these outhouses some attempt at removal of 
excreta and at cleaning up at the beginning of the school year was 
apparent. The vast majority of these outhouses are simply set on 
the ground and are freely open beneath and at the back, thereby 
allowing free access of flies, animals, etc., to the excreta. In a con- 
siderable number of the outhouses objectionable odors w^ere so strong 
as to make it practically impossible to remain within. In a very few 
a urine trough had been provided in the outhouses for boys, while 
in others the seats and floors were urine soaked and gave forth 
strong odors. As a rule the outhouses are located at from 60 feet to 
100 feet aw^ay from the school buildings. 

Seventy sets of outhouses were inspected as to their being provided 
with suitable screens in front of them. Forty-two sets of outhouses 



IND. 

were noted as having proper screens in front of them. Twenty- 
eight sets of outhouses were without screens. These screens w^ere 
classified as good, fair, and bad, according to their condition. Thirty- 
one were good; ^yo were fair, and six were bad. 

Outhouses J with relation to source of water sujjply and drainage. — In 
one instance, that of district school No. 4, Ohio Township, the source 
of water supply (a well) was noted as being 30 feet away from the 
outhouses. In tw^o other instances the wells were noted as being 
about 50 feet distant from the outhouses. At stiU two other rural 
schools the wells were about 60 feet distant. At the other rural 
schools the average distance of the weUs from the outhouses was from 
75 feet to 150 feet. The majority of the wells average 100 feet from 
the outhouses. At a limited number of rural schools the source of 
water supply was from 15 rods to one-fourth mile distant. At two 
rural schools the slope of the school yards w^as such as to permit of sur- 
face drainage from the outhouses into the wells. At the large majority 
of the schools the grounds were either level or nearly so, while at a few 
the outhouses were situated at the lower part of sloping grounds, and 
the drainage was distinctly away from the wells. 

Sources of Water Supply, 

Seventy-two schools inspected are suppUed with drinking water 
from wells, cisterns, or springs. Of this num^ber 35 are supplied from 
driven wells, 33 from open or dug wells, 3 from cisterns supplied with 
rainwater from roofs of schools buildings, and one from a spring. The 
remainder are supplied with city water. The. wells, as a rule, are 
shallow. Few exceed 40 feet in depth. The average depth is from 
20 to 25 feet. The driven weUs are mostly in the low, level sections 
of the country, while the dug weUs are more frequently seen in the 
hilly sections. Owing to the dry summer season w^hich had prevailed 
in that part of Indiana a number of the school wells were not being 
used at the time of the survey, some having gone completely dry, 
while in others the w^ater was low and scant in amount. This was 
mostly the case in the hilly section of the county. While a number 
of the wells w^ere covered with concrete, whether driven or dug, the 
majority of them were covered simply with boards. 

Kind of Drinking Cups Used. 

Seven schools in Columbus have drinkhig fountains installed. Out- 
side of Columbus eight schools use individual drinking cups. Twenty- 
four schools still use the common driaking cup, and 43 schools use 
both the common and individual cups. In explanation of the large 
number of schools still using both individual and common cups it 
might be said that, in many instances, practically all the children of 
a school would be supplied mth individual cups, while still at the 



SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IND. 7 

pump the common cup would be found in use, thus hi a measure 
destroyhig the benefit conferred by usmg the individual cup. 

In nine rural schools the common water bucket was found in use. 

In four rural schools water coolers were used. In the remainder 
of the rural schools the water is pumped or drawn from the well as 

required. 

Drainage from Pumps, etc. 

In 28 instances the school wells were found to be supplied with 
satisfactory drains or troughs. 'In 20 instances the wells were not 
supplied with drains or troughs. In 11 instances a drain or trough 
was supplied; but was unsatisfactory and allowed the water to reach 
the well again, or was too short to carry the overflow water away 
from the well to a satisfactory distance. In 2 instances it was noted 
that the overflow water from the pump fell directly back into the 
well through coarse-screened openings in the well cover. With one 
exception, all of these defects were noted at rural schools. 

Disinfection and Special Cleansing of Schoolhouses. 

Of the 83 total schools visited and inspected 76 were reported as 
having been specially cleaned and disinfected before the beginning of 
the school year. Seven schools were reported as having been spe- 
cially cleaned before the openuig of school, but not disinfected. The 
method of disinfection of schoolrooms by the county health depart- 
ment 13 by formaldehyd gas, evolved from the combination of wood 
alcohol and potassium permanganate. 

Lighting of Schools. 

In the township consolidated, town, and city schools the lighting 
is good. In all of these buildings the light is admitted from the left 
side of the rooms. The Indiana laws require that the window or 
lighting area of a room shall be not less than one-sixth of the floor 
area. In all the above buildings the law has been fully complied 
with and there is in all an excess of illuminating surface beyond what 
is required. With the light coming from but one side of a room there 
can be no cross-lights. The case was found to be different in the 
rural school buildings, the majority of which are old, many of them 
having been erected a quarter of a century ago. In the sixty-odd 
rural school buildings inspected in this respect, practically all, with 
the exception perhaps of some dwellings used temporarily for school 
purposes, were sufficiently lighted. A number of schools, in which 
the window area as compared to the floor area was estimated, ex- 
ceeded the requirement by from 10 to 15 per cent. The usual 
custom of Hghting the rooms from both sides was adhered to in a 
large proportion of these schools, while a few of them were found to 



8 SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IND. 

be lighted from both sides and also the front. In 46 rural school- 
rooms bad cross-Ughts were found to exist. In 10 rural schools 
the cross-lights were not bad. One room was found to be insuffi- 
ciently lighted, and in one the school children sat facing the Hght. 

Color of Interior Walls and Ceilings. 

In the city, town, and township consoHdated schools some uni- 
formity existed as to the color of walls and ceilings; that is, some one 
color scheme had been carried out in a building. Possibly light gi'een 
colored walls and ceilings predominated. In a number of buildings 
ocher was the color selected for the finish. Still other buildings had 
light gray and drab colored walls and ceilings. In the rural schools 
many of the rooms were papered. Generally some attempt at uni- 
formity of color was found in the schools of a township. This 
resulted from the fact of one individual, the trustee, having selected 
the colors. The selection of colors for finish of interior of rooms 
seems, however, to have been left entirely to the fancy of the indi- 
vidual selecting them in the various towsliips. Green, gray, ocher, 
yellow, orange, white, brown, blue, and rose, of many shades were 
observed. A moderately light-green shade for the walls vnth a 
lighter ceHing of the same color is the finish usually adopted for 
schoolrooms at the present time. 

Heating. 

The Columbus city schools, the Hope High School, and three town 
and consohdated school buildings are heated by steam. Five town 
and consohdated township schools are heated by ^ ^sanitary heaters." 
Three schools are heated by hot-air furnaces. Forty-one schools are 
heated by coal stoves and 23 are heated by wood stoves. The 
method of heating rural schools was found to be cliiefly by means of 
stoves. 

It is impracticable to use steam for heating schools, except in the 
larger or consoHdated buildings provided vdth basements. The patent 
or ^'sanitary heater" referred to appears to be a good type of heater 
to use in smaller schools in town or country. This heater is practi- 
cally a jacketed coal stove located in the room to be heated. Fresh 
air from v/ithout gains access at the bottom of the jacket from a 
piped wall inlet. The fresh air becoming warmed by contact with 
the exterior of the stove rises, and passing upward to the top of the 
jacket, some 5 feet above the floor, escapes into the room. An 
attached receptacle for water, placed on top of the heater, preserves 
a proper degree of moisture in the room ah*. 

The heating of the country school is a question. Until the consol- 
idated rural school is more universally in use there will remain the 
one-room rural school and the vexed problem of heatmg it. This, as 



SCHOOL SANITAKY SURVEY, BARTHOLOMEW COUNTY, IND. 9 

we know, is generally done by stoves, and in a cold climate this is an 
unsatisfactory method. The floors are always cold and the children 
suffer cruelty from chilblains and colds. While the upper part of the 
room is too warm, the outer row of seats is in an icy atmosphere, and 
the whole room suffers from bad air. It is believed the type of san- 
itary heater mentioned would in a measure solve the problem of heat- 
ing countiy schools. This method is well worth a trial, and the 
increased cost would not prove excessive. This type of heater sup- 
plies fresh warmed air in the room, where frequently foul air exists, 
and mamtains a more uniform temperature ia the room than the 
ordinary stove. 

Ventilation. 

Various methods of ventilation were found to exist in the schools. 
Natural ventilation, which is afforded by perflation of air through 
open windows and doors and what percolates by cracks and crevices, 
without any special provisions for outlet of foul air, was found to exist 
in 55 of the schools visited. Natural ventilation was the method 
mostly observed in the rural school. Natural ventilation with addi- 
tional fresh-air inlets was found in two schools. Natural ventilation 
with additional fresh-air inlets and foul-air outlets was found in three 
schools. Natural ventilation with additional foul-air outlets was also 
noted in two other schools. The schools supplied with the accessory 
forms of natural ventilation were of the rural type with but one or 
two exceptions. In schools where steam was used for heating, as in 
the Columbus schools and a few others, warmed fresh air, introduced 
from without through the radiators, is constantly supplied to the 
schoolrooms and foul air is removed by means of specially constructed 
outlets and air shafts. 

In six schools, where sanitary heaters and furnaces are provided, 
warmed, fresh air is supplied the schoolrooms, and special foul-air 
outlets and shafts are also provided. 

In the more recently constructed city of Columbus schools, in 
those of more recent construction in the towns, and in the central 
or township consolidated schools, the ventilation is good. There 
does not appear to be overcrowding of the school children, and the 
usual allowance of cubic air space per capita is not curtailed. 

In many of the rural schools the conditions were different. 
Although the weather was warm at the time of the inspection, and 
heat was not required, many of the schools were found with closed 
doors and closed windows, and the odor of foul air was noticeably 
perceptible. It is believed that many of the school children in the 
rural school suffer from the effects of bad ventilation. The main- 
tenance of the normal moisture of the air of schoolrooms is neces- 
sary if comfort and good health are to be expected. 



10 SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IXD. 

The methods found in use in the schools for maintaining the 
moisture of the air were noted, as follows : In 68 schoolrooms the 
air was supplied with moisture from vessels on the stoves. In 10 
schoolrooms the air was supplied with moisture from steam radi- 
ators, and in 5 schoolrooms there were no visible means of supply- 



ing moisture. 



Cloakrooms. 



A matter of no small importance in schools is that of having 
separate cloakrooms. All schools should be provided with them. 
They can be provided at a slightly increased cost, and do much m 
the way of promoting the hygiene of the schoolroom. Wet and soiled 
and frequently bad-smelling clothes are hung up in these rooms, and 
thus are kept out of the schoolroom. 

Of the schools inspected, 52 were provided with cloakrooms for 
keeping ^vraps, lunches, etc.; 31 schools had no special rooms for 
clothing, and the wraps and lunches as well were kept in the school- 
room proper. This absence of a special cloakroom was noticed to be 
confined entirely to the rural schools. 

Facilities for Washing Hands and Face. 

The facilities provided for washing hands and face were shown to 
be somewhat varied. Of the 83 schools inspected, six city schools in 
Columbus are provided with lavatories. The Booker T. Washington 
Colored School in this city is provided with a stationary washbasin, 
located underneath the sanitary drinking fountain, for purposes of 
washing hands and face. 

At the high school in Hope no facilities are provided for this pur- 
pose beyond the pump at the well. Here, however, the school chil- 
dren mostly wash at home. In the East Columbus consolidated 
school, with about 300 scholars enrolled, the common washbasin is 
used in all room_s except the one presided over by the principal. The 
children in this room wash their hands and faces at home. 

At the Hartsville School the children wash at home, or, if at school, 
at the pump in the yard. 

At the Hawcreek consolidated school the school children wash in 
a common washbasin in a sink in the basement. 

At three schools no provision was made for washing, and the chil- 
dren are expected to do this at home, as in all instances they live in 
the towns nearby. In three country schools, no provision whatever 
was made for washing hands and face. In 31 rural schools the com- 
mon washbasin was found to be still in use. 

In the movement for the promotion of hygiene in schools, and the 
discarding of the common towel and common drinking cup, the com- 
mon washbasin should be included. It is a dirty, objectionable 



SCHOOL SANITAEY SURVEY, BARTHOLOMEW COUNTY, IND. 11 

vessel at best in a schoolroom, and in sections where water is scarce, 
the same Avash water is frequently used by a number of different 
school children. 

The Use of Towels in Schools. 

Notwithstanding the campaign against the common towel in 
schools, it still continues to be used to a great extent, as my inspec- 
tion showed. Unless its use is prohibited by law and this is strictly 
enforced, the common towel will continue to be used in many schools 
in the future. In the course of the survey, teachers were encoun- 
tered who beheved the common towel was all right, and saw no 
objection to its use by the school children. 

The survey showed that in five schools in Columbus paper towels 
Only were used. In the Columbus Central High School the common 
towel was still found in use, but I was informed that thereafter paper 
towels would be used in that school also. In the East Columbus 
consolidated school common towels were used in aU rooms, except 
in the room in charge of the principal, where none was used. In the 
Hawcreek township consohdated school no com^mon towel was used. 
The school children must use handkerchiefs or individual towels. In 
a number of the other consohdated and town schools the same rule 
applied. In the town schools, however, the school children have the 
advantage of the nearness to their homes in this respect. 

In 24 schools (mostly rural) the common towel was found in use, 
and in 49 others (mostly rural) individual towels or none were used. 
Here must be explained the term 'individual towel." It can mean 
anything — -from a handkerchief or a piece of cloth to an individual 
towel. In most cases where the common towel was not used a 
handkerchief or a piece of cloth answered the purpose of a towel. 
In a number of schools nothing is used for wiping the hands and face 
after washing. They are simply allowed to dry by exposure to the 
air. 

Adjustable Seats. 

In making the survey, adjustable seats were a matter to which 
attention was paid. Now that adjustable seats for school children 
of aU sizes are available, they should be provided in aU schools. No 
longer should an inspector enter a school, city or country, and see 
children sitting on seats so high that their feet are suspended in the 
air. AU seats and desks should be adjusted to the occupant. In aU 
cases the seat should have such a relation to the desk top and the 
floor as to afford an easy natural position to the child. 

Of the 83 schools inspected only 17 were provided with adjustable 
seats. The number of adjustable seats provided per school varied. 
In one school in Columbus 5 per cent of the seats were of the adjust- 



12 SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IND. 

able type. In two more schools in that city one-sixth and one-fifth 
of the number of seats provided, respectively, were adjustable. Two 
schools in Columbus had none. In the HartsviUe School 46 per cent 
of the seats are adjustable. In the Hawcreek Township consohdated 
school no adjustable seats were found, although 25 adjustable seats 
had been ordered. In the East Columbus Township consohdated 
school, with an enroUment of 330 school children, only 37 adjustable 
seats were found. In the Hope School about the same proportion of 
adjustable seats was found. In Flatrock Township 78, or 29 per 
cent, adjustable seats were provided in three schools, with an enroU- 
ment of 270 children. In three schools in Clifty Township, with an 
enrollment of 132 children, there were 29, or 22 per cent, in two schools 
and none in the third. In a total of ^yg schools in Rockcreek Town- 
ship 66, or 63 per cent, adjustable seats were found in four schools 
where the enrollment was 104, while the fifth school, with 2 rooms 
and 42 scholars enrolled, had none. 

In 61 schools, or 73^ per cent, mostly rural, no adjustable seats 
were found. 

Location of Eiackboards. 

Attention was given to the location of blackboards also in making 
the survey. Blackboards can be placed either too high on the walls 
so as to be above the reach of the smaller children, or again placed 
too low, requiring the children to stoop. Both of these defects in 
location add to the discomfort of the child and the it aU the more 
quickly. Again, the location of the blackboards with reference to 
the hght reaching them from one side (left preferably), from being 
equally distributed over the entire surface, or so as not to cause con- 
fusion and shadows, should always be borne in mind. With these 
points in view, the results of the survey were as f oUovvs : 

In 44 schools the blackboards were properly located. In 39 schools 
the blackboards were improperly placed. This is a matter of much 
hygienic importance to the school children. Improperly located 
blackboards lead to eyestrain, while properly located and lighted 
boards are a pleasure for the children to work at. In a number of 
the schools the blackboards were found to extend into corners and 
hence to include angles. No worse locations could be selected for 
blackboards than corners, for the hght always must be bad there. 
The material of the blackboards inspected was black-painted boards 
or black-painted plaster, and in some schools slate stone was used. 
In ail the newer, consolidated, and town schools, the blackboards 
were found properly placed. In the country schools mainly the 
defects as to location and proper illumination were observed. 



SCHOOL SANITAKY SURVEY, BARTHOLOMEW COUNTY, IND. 13 
Health of School Children. 

In making the survey the occurrence of contagious and infec- 
tious diseases among the school children was especially sought for, 
particular attention being paid to the search for trachoma and 
defective oral and pharyngeal conditions. Organic diseases, deformi- 
ties of back and limbs, defective hearing, defective speech, and 
mentally dull and backward children were observed. 

In general, the 4,000 school children examined throughout the 
county were found to be well nourished and in good health, as was 
evidenced by their roSy complexions, sparkling eyes, and vivacity. 
In some of the western townships, in the hilly and less fertile sections 
of the county, some of the children appeared to be not well nourished. 

In making the survey, it was desired to ascertain how many school 
children were suffering from defective teeth. The defects observed 
in a cursory examination would have doubtless been greatly increased 
had the examination been made from a dentist's point of view, 
with the use of mirror and probe. The age of the children examined 
ranged from 6 to 14 years for the rural and graded schools, and 
higher for the high schools. In the 3,969 school children examined, 
1,435, or 38.67 per cent, had defective teeth, ranging from one tooth 
to three or four or more defective teeth per child. 

Five himdred and thirty-nine children, or 14 per cent of the total 
number examined, had enlarged tonsils. It is safe to estimate that 
fully 25 per cent, or 125, of that number, also have adenoids. 

There was no noticeable difference in the proportion of enlarged 
tonsils observed in school children in towns from those in the rural 
schools. 

Trachoma. — Trachoma was found to exist in 20 schools in 8 town- 
ships, 1 town, and 1 city. Forty-eight cases of well-marked tra- 
choma were found in the 3,969 school children examined, or 1.2 per 
cent. Twenty cases of trachoma were found in 11 county schools 
and 1 township consolidated school. Fourteen cases were foim.d 
in 6 Columbus schools, 11 cases were found in the East Columbus 
consolidated school, and 3 in the high school, town of Hope. In 
the country schools, 6 cases were found in 1 school in Wayne Town- 
ship. From the above it will be noted that trachoma is most preva- 
lent in the two townships, Columbus and Wayne. Thirty-four cases 
were found to exist in these two townships. 

An interesting feature of the existence of six cases of trachoma in 
one rural school, in "Wayne Township, is that five of the cases are in 
two families; two cases being in one family and three cases being in 
another family. In another county school with two cases, both cases 
were in one family. An interesting feature, as showing the conta- 



11 SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IND. 

giousness of the disease, was observed in this family. The two chil- 
dren at the school with trachoma, upon being asked whether any 
other members of the family had sore eyes, replied that there wer-e 
two older sisters in the family and that both had had sore eyes for 
years. Their home was near the school and it was next visited. 
There it was learned that of a family of six, five had sore eyes. The 
wife, a second one, who had not been a member of the household 
long, was the only member free from the disease. The father, who 
was absent at the time, had had sore eyes for a number of years, and 
subsequently the two older daughters had developed sore eyes. 
Both older daughters lived away from home and could not be seen. 
One of the sisters was reported as being almost blind from her eye 
trouble. Of the three cases of trachoma seen in the Hope High 
School, two were in one family — brothers. Also two cases seen in the 
Central High School, Columbus, were brothers. 

In the East Columbus Township consolidated school, 11 well- 
marked cases of trachoma were found. In this school 330 children 
are enrolled and 290 were present and examined, the percentage of 
cases there being 3.8 per cent. In district No. 2 school, Wayne Town- 
ship, with six cases of trachoma found in 32 school children examined, 
the percentage rate is 19 per cent. An interesting feature in con- 
nection with the extent of trachoma in the East Columbus Town- 
ship consolidated school may here be reported. It was noted that 
in all rooms beside that of the principal, a common towel was used 
by the school children. Here is an instance where the use of the 
common towel might easily have acted as a disseminator of the 
disease. 

School children found suffering with trachoma ranged from 6 to 16 
years of age, and it was about equally prevalent in both boys and 
girls, 20 being in the forner and 28 in the latter. In a number of 
these cases there was a decided discharge from the eyes, denoting the 
acuteness of the disease. Other cases had apparently passed beyond 
this stage. In all, the granulations were large and plentiful. 

With the exception of one family in which trachoma existed and 
which had come into the county some two years previously from Ken- 
tucky, all the school children found to be suffering from trachoma 
were born in Indiana as far as ascertained and many of them in 
Bartholomew County, although they had not always lived in the 
same locality. 

Doubtless trachoma had existed in Bartholomew County for years 
and was introduced either from some other part of the State or from 
other States or was brought in from Europe by immigrants. 



SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY, IND. 15 



Trachoma and cases suspicious of trachoma in Bartholomew County, Ind., schools, Sep- 
tember-October, 1913. 



Township. 



Suspicious. 




Sandcreek 

Rockcreek 

Haxrison 

Wayne 

Clay 

German 

Columbus 

East Columbus consolidat ed schools 

Hawcreek Tow-nship consolidated school; 

Hope High School 

Columbus- 
Central High School 

Washington School 

Jefferson School 

McKinley School 

Garfield School 

Lincoln School 

Total 



Follicular conjunctivitis. — Twenty cases of follicular conjunctivitis 
were observed in the school children in 14 schools. This disease was 
noted to be prevalent more in children in the rural schools. Sixteen 
cases were found in 13 country schools and four cases in one school in 
Columbus. 

Impetigo contagiosa. — Three cases of impetigo contagiosa were ob- 
served in children in one school. Investigation showed that these 
cases were all members of one family. No other cases of this disease 
were noted. 

Summary. 

This report would not be complete without some reference being 
made to the rapid strides in the way of improvement going on in the 
rural schools of Bartholomew County. The movement in the way 
of providing more sanitary buildings and grounds, with a correspond- 
ing bettering in educational facilities, is mush in evidence. Chief in 
this respect is the establishment in rural districts of central or con- 
solidated schools. By so doing, the consolidated school absorbs 
anywhere from 3 to 10 or more one-teacher, one-room rural schools, 
according to the school population of a township. This central 
school building is constructed in accordance with the latest approved 
ideas of school architecture, and is properly heated, lighted, and ven- 
tilated. Excreta is disposed of by the crematory method. Sanitary 
drinking fountains supplied from a deep well, by air pressure, take 
the place of the common cup, the common water bucket, and the 
shallow well, so frequently seen much in evidence in the one-room 
rural school. 

By consolidation, the rural schools become graded in the central 
school, thereby affording the school children a marked advantage, 



16 SCHOOL SANITARY SURVEY, BARTHOLOMEW COUNTY^ IND. 

not only in the way of providing comfortable and sanitary school- 
rooms, but also in the way of providing far better educational 
features. 

A number of these excellent consolidated township schools were 
visited in the course of the survey, and if especial reference could be 
made to any one of them, doubtless the Hawcreek Township con- 
solidated schools would be considered. Previous to the establish- 
ment of this consolidated school, 11 one-room rural schools existed 
in the township, presided over by a like number of teachers. With 
the placing of all these schools under one roof, the work is now done 
by seven teachers, and the school is graded. Additional courses, 
such as manual training, domestic science, etc., which were not taught 
in the one-room schools, have been added. The children are trans- 
ported to and from the school. It was an interesting sight to see 
11 large, comfortable, heated vans, each accommodating about 20 
children, drawn up to the school at the end of the day to carry the 
200 school children to their respective homes. I was informed that 
at this school no child walked. All rode to and from school. The 
fine assembly room is the social center of the community. 



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acuse, N. Y. 
PAT. JAN. 21, 1908 






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